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Nodal Differentiated Thyroid Carcinoma
Surjith Vattoth, MD, FRCR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Differentiated thyroid carcinoma (DTC)
              • Definitions

                • Metastatic node(s) from DTC [papillary thyroid carcinoma (PTC) or follicular thyroid carcinoma (FTC)]

              IMAGING

              • General Features

                • Imaging Recommendations

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Nuclear Medicine Findings

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Liu X et al: The impact of radioactive iodine treatment on survival among papillary thyroid cancer patients according to the 7th and 8th editions of the AJCC/TNM staging system: a SEER-based study. Updates Surg. 72(3):871-84, 2020
                                          2. Zhao H et al: Risk factors for skip metastasis and lateral lymph node metastasis of papillary thyroid cancer. Surgery. 166(1):55-60, 2019
                                          3. Lan X et al: A meta-analysis of central lymph node metastasis for predicting lateral involvement in papillary thyroid carcinoma. Otolaryngol Head Neck Surg. 153(5):731-8, 2015
                                          4. Wei T et al: Predictive factors of contralateral paratracheal lymph node metastasis in unilateral papillary thyroid carcinoma. Eur J Surg Oncol. 41(6):746-50, 2015
                                          5. Wu MH et al: Prognostic significance of extranodal extension of regional lymph node metastasis in papillary thyroid cancer. Head Neck. 37(9):1336-43, 2015
                                          6. Yeh MW et al: American Thyroid Association statement on preoperative imaging for thyroid cancer surgery. Thyroid. 25(1):3-14, 2015
                                          7. Coquia SF et al: The role of sonography in thyroid cancer. Radiol Clin North Am. 52(6):1283-94, 2014
                                          8. Mizrachi A et al: Value of ultrasound in detecting central compartment lymph node metastases in differentiated thyroid carcinoma. Eur Arch Otorhinolaryngol. 271(5):1215-8, 2014
                                          9. Su HK et al: Striving toward standardization of reporting of ultrasound features of thyroid nodules and lymph nodes: a multidisciplinary consensus statement. Thyroid. 24(9):1341-9, 2014
                                          10. Vannucchi G et al: Ultrasound-guided percutaneous ethanol injection in papillary thyroid cancer metastatic lymph-nodes. Endocrine. 47(2):648-51, 2014
                                          11. Wang LY et al: Central lymph node characteristics predictive of outcome in patients with differentiated thyroid cancer. Thyroid. 24(12):1790-5, 2014
                                          12. Xiang D et al: Contrast-enhanced ultrasound (CEUS) facilitated US in detecting lateral neck lymph node metastasis of thyroid cancer patients: diagnosis value and enhancement patterns of malignant lymph nodes. Eur Radiol. 24(10):2513-9, 2014
                                          13. Giacomini CP et al: Ultrasonographic evaluation of malignant and normal cervical lymph nodes. Semin Ultrasound CT MR. 34(3):236-47, 2013
                                          14. Li QK et al: Thyroglobulin measurements in fine-needle aspiration cytology of lymph nodes for the detection of metastatic papillary thyroid carcinoma. Cancer Cytopathol. 121(8):440-8, 2013
                                          15. Shin LK et al: Sonographic evaluation of cervical lymph nodes in papillary thyroid cancer. Ultrasound Q. 29(1):25-32, 2013
                                          16. Lim YC et al: Occult lymph node metastases in neck level V in papillary thyroid carcinoma. Surgery. 147(2):241-5, 2010
                                          17. Kaplan SL et al: The role of MR imaging in detecting nodal disease in thyroidectomy patients with rising thyroglobulin levels. AJNR Am J Neuroradiol. 30(3):608-12, 2009
                                          18. Lim YC et al: Central lymph node metastases in unilateral papillary thyroid microcarcinoma. Br J Surg. 96(3):253-7, 2009
                                          19. Rotstein L: The role of lymphadenectomy in the management of papillary carcinoma of the thyroid. J Surg Oncol. 99(4):186-8, 2009
                                          20. Schmidt D et al: Impact of 131I SPECT/spiral CT on nodal staging of differentiated thyroid carcinoma at the first radioablation. J Nucl Med. 50(1):18-23, 2009
                                          21. Roh JL et al: Central cervical nodal metastasis from papillary thyroid microcarcinoma: pattern and factors predictive of nodal metastasis. Ann Surg Oncol. 15(9):2482-6, 2008
                                          22. Roh JL et al: Lateral cervical lymph node metastases from papillary thyroid carcinoma: pattern of nodal metastases and optimal strategy for neck dissection. Ann Surg Oncol. 15(4):1177-82, 2008
                                          23. Soler ZM et al: Utility of computed tomography in the detection of subclinical nodal disease in papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 134(9):973-8, 2008
                                          24. Sugitani I et al: Prospective outcomes of selective lymph node dissection for papillary thyroid carcinoma based on preoperative ultrasonography. World J Surg. 32(11):2494-502, 2008
                                          25. Yanir Y et al: Regional metastases in well-differentiated thyroid carcinoma: pattern of spread. Laryngoscope. 118(3):433-6, 2008
                                          26. Leboulleux S et al: Ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for differentiated thyroid cancer. J Clin Endocrinol Metab. 92(9):3590-4, 2007
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Differentiated thyroid carcinoma (DTC)
                                                      • Definitions

                                                        • Metastatic node(s) from DTC [papillary thyroid carcinoma (PTC) or follicular thyroid carcinoma (FTC)]

                                                      IMAGING

                                                      • General Features

                                                        • Imaging Recommendations

                                                          • CT Findings

                                                            • MR Findings

                                                              • Ultrasonographic Findings

                                                                • Nuclear Medicine Findings

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Liu X et al: The impact of radioactive iodine treatment on survival among papillary thyroid cancer patients according to the 7th and 8th editions of the AJCC/TNM staging system: a SEER-based study. Updates Surg. 72(3):871-84, 2020
                                                                                  2. Zhao H et al: Risk factors for skip metastasis and lateral lymph node metastasis of papillary thyroid cancer. Surgery. 166(1):55-60, 2019
                                                                                  3. Lan X et al: A meta-analysis of central lymph node metastasis for predicting lateral involvement in papillary thyroid carcinoma. Otolaryngol Head Neck Surg. 153(5):731-8, 2015
                                                                                  4. Wei T et al: Predictive factors of contralateral paratracheal lymph node metastasis in unilateral papillary thyroid carcinoma. Eur J Surg Oncol. 41(6):746-50, 2015
                                                                                  5. Wu MH et al: Prognostic significance of extranodal extension of regional lymph node metastasis in papillary thyroid cancer. Head Neck. 37(9):1336-43, 2015
                                                                                  6. Yeh MW et al: American Thyroid Association statement on preoperative imaging for thyroid cancer surgery. Thyroid. 25(1):3-14, 2015
                                                                                  7. Coquia SF et al: The role of sonography in thyroid cancer. Radiol Clin North Am. 52(6):1283-94, 2014
                                                                                  8. Mizrachi A et al: Value of ultrasound in detecting central compartment lymph node metastases in differentiated thyroid carcinoma. Eur Arch Otorhinolaryngol. 271(5):1215-8, 2014
                                                                                  9. Su HK et al: Striving toward standardization of reporting of ultrasound features of thyroid nodules and lymph nodes: a multidisciplinary consensus statement. Thyroid. 24(9):1341-9, 2014
                                                                                  10. Vannucchi G et al: Ultrasound-guided percutaneous ethanol injection in papillary thyroid cancer metastatic lymph-nodes. Endocrine. 47(2):648-51, 2014
                                                                                  11. Wang LY et al: Central lymph node characteristics predictive of outcome in patients with differentiated thyroid cancer. Thyroid. 24(12):1790-5, 2014
                                                                                  12. Xiang D et al: Contrast-enhanced ultrasound (CEUS) facilitated US in detecting lateral neck lymph node metastasis of thyroid cancer patients: diagnosis value and enhancement patterns of malignant lymph nodes. Eur Radiol. 24(10):2513-9, 2014
                                                                                  13. Giacomini CP et al: Ultrasonographic evaluation of malignant and normal cervical lymph nodes. Semin Ultrasound CT MR. 34(3):236-47, 2013
                                                                                  14. Li QK et al: Thyroglobulin measurements in fine-needle aspiration cytology of lymph nodes for the detection of metastatic papillary thyroid carcinoma. Cancer Cytopathol. 121(8):440-8, 2013
                                                                                  15. Shin LK et al: Sonographic evaluation of cervical lymph nodes in papillary thyroid cancer. Ultrasound Q. 29(1):25-32, 2013
                                                                                  16. Lim YC et al: Occult lymph node metastases in neck level V in papillary thyroid carcinoma. Surgery. 147(2):241-5, 2010
                                                                                  17. Kaplan SL et al: The role of MR imaging in detecting nodal disease in thyroidectomy patients with rising thyroglobulin levels. AJNR Am J Neuroradiol. 30(3):608-12, 2009
                                                                                  18. Lim YC et al: Central lymph node metastases in unilateral papillary thyroid microcarcinoma. Br J Surg. 96(3):253-7, 2009
                                                                                  19. Rotstein L: The role of lymphadenectomy in the management of papillary carcinoma of the thyroid. J Surg Oncol. 99(4):186-8, 2009
                                                                                  20. Schmidt D et al: Impact of 131I SPECT/spiral CT on nodal staging of differentiated thyroid carcinoma at the first radioablation. J Nucl Med. 50(1):18-23, 2009
                                                                                  21. Roh JL et al: Central cervical nodal metastasis from papillary thyroid microcarcinoma: pattern and factors predictive of nodal metastasis. Ann Surg Oncol. 15(9):2482-6, 2008
                                                                                  22. Roh JL et al: Lateral cervical lymph node metastases from papillary thyroid carcinoma: pattern of nodal metastases and optimal strategy for neck dissection. Ann Surg Oncol. 15(4):1177-82, 2008
                                                                                  23. Soler ZM et al: Utility of computed tomography in the detection of subclinical nodal disease in papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 134(9):973-8, 2008
                                                                                  24. Sugitani I et al: Prospective outcomes of selective lymph node dissection for papillary thyroid carcinoma based on preoperative ultrasonography. World J Surg. 32(11):2494-502, 2008
                                                                                  25. Yanir Y et al: Regional metastases in well-differentiated thyroid carcinoma: pattern of spread. Laryngoscope. 118(3):433-6, 2008
                                                                                  26. Leboulleux S et al: Ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for differentiated thyroid cancer. J Clin Endocrinol Metab. 92(9):3590-4, 2007